Battal Tahsin Somuk

Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy.

OBJECTIVE Children with chronic adenotonsillar hypertrophy (CAH) are more likely to have symptoms of attention deficit hyperactivity disorder (ADHD) and enuresis nocturna (EN) and benefit from surgery. The aim of this study was to evaluate the effect of adenotonsillectomy on ADHD and EN symptoms in children with CAH. STUDY DESIGN Cross-sectional study was conducted. SETTING Parent-based questionnaires. METHODS Parents of children with CAH were given Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV) and Nocturnal Enuresis Questionnaire (NEQ) before and six months after adenotonsillectomy. Inattention (IA) and hyperactivity-impulsivity (HI) subscores of T-DSM-IV were used in the present study. The rates of ADHD and EN were compared before and after surgery. RESULTS A total of 75 children between 5 and 16 years of age and their families participated in the study. All 75 families completed T-DSM-IV and NEQ. Mean IA (5.69 ± 4.88 versus 4.46 ± 4.40) and HI (6.53 ± 5.60 versus 5.93 ± 5.45) scores as well as total ADHD scores (12.22 ± 8.99 versus 10.42 ± 8.70) improved significantly after surgery. This significance was found to be statistically important (p<0.05). Furthermore 26 of the subjects were diagnosed with primer EN before adenotonsillectomy and 14 of these enuretic children had total remission six months after surgery. The frequency of EN dropped from 34.7% to 16.0% and this remission rate was found to be statistically significant (p<0.05). CONCLUSION Children with CAH had high frequency of ADHD and EN symptoms in the present study. Adenotonsillectomy was found to be effective in improvement of these symptoms.

Mean platelet volume as an inflammatory marker of chronic otitis media with effusion

OBJECTIVES Our aim was to investigate whether mean platelet volume (MPV) may be utilized as an inflammatory marker of chronic otitis media with effusion (COME). METHODS Routine hemogram tests were performed preoperatively for 51 patients diagnosed with COME that were to receive ventilation tube insertion. Hemogram tests were performed on age-matched and sex-matched healthy controls (n=54). Moreover, by performing a chart review, white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), platelet (PLT), and mean platelet volume (MPV) values were compared between COME patients and controls. RESULTS A total of 51 COME patients were included in the study and 45.1% were male. The control group had 54 individuals and 51.9% were male. MPV (p=0.493) and platelet levels (p=0.336) for COME patients group were generally borderline higher than those measured for the control group, but this difference was not statistically significant. CONCLUSION No statistically significant differences were identified between pediatric patients diagnosed with COME and healthy controls in terms of WBC, RBC, Hb, Hct, PLT and MPV levels.

Paraoxonase Activity and Oxidative Status in Patients with Tinnitus

Background and Objectives The aim of this study was to investigate serum paraoxanase-1 (PON) activity, total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) in tinnitus; and to compare the results with data from healthy subjects. Subjects and Methods A total of 114 subjects-54 patients with tinnitus and 60 healthy controls were enrolled in this study. Serum PON activity, TOS, TAS, and OSI levels were measured. Results In the tinnitus group, TAS, and PON were significantly lower than in the control group (p<0.001). However, the TOS, and OSI levels were significantly higher in the tinnitus group than in the control group (p<0.001). Conclusions According to the data obtained from the present study, patients with tinnitus were exposed to potent oxidative stress. Oxidative stress may be the key contributing factor to the pathogenesis of tinnitus.

Protective effects of melatonin and selenium against apoptosis of olfactory sensory neurons: A rat model study.

Background Selenium plays a role in the prevention of oxidative damage and has been linked to regulatory functions in cell growth, apoptosis, cell survival, and cytotoxicity. Melatonin has an antioxidant effect, which protects against a number of free radical species. Given its antioxidant properties, melatonin has been widely known to inhibit neuronal apoptosis. We examined the cytoprotective effects of melatonin and selenium in rat olfactory sensory neurons after rhinosinusitis by immunohistochemical evaluation of olfactory bulb mucosa. Methods Rhinosinusitis was induced bilaterally in 24 animals. Twenty-four rats were randomly divided into three equal groups. The melatonin group was treated with intraperitoneal (i.p.) melatonin and ampicillin-sulbactam, the selenium group was treated with i.p. selenium and ampicillin-sulbactam, the antibiotic group was treated with i.p. ampicillin-sulbactam; all three groups were treated for 10 days. After a period of 10 days of treatment, the animals were killed for immunohistochemical analyses. All olfactory bulb mucosae were removed immediately. Results No histochemical differences were found in the three groups. Terminal deoxynucleotidyl transferase 2′-deoxyuridine 5′-triphosphate nick end labeling–positive cells were detected in each group. In the antibiotic group, the appearance of apoptotic cells was higher, whereas the number of apoptotic cells significantly decreased in the melatonin group. When compared with the selenium group, fewer terminal deoxynucleotidyl transferase 2′-deoxyuridine 5′-triphosphate nick end labeling–positive cells were observed in the melatonin group, which was not significant. In the antibiotic group, the cytoplasmic active caspase-3 and Bax immunostaining in the olfactory epithelium and glandular cells of stroma were higher when compared with the immunostaining in melatonin and selenium groups. Active caspase-3 and Bax immunostaining in the subepithelial stroma was dramatically reduced in the melatonin group. In contrast, the staining intensity and the number of Bcl-2 immunopositive cells were significantly increased in the melatonin group. In the selenium group, Bax and active caspase-3 were moderately immunopositive in the epithelium and subepithelial stroma. However, Bcl-2 immunostaining was more pronounced in the olfactory epithelium and some stromal cells. Conclusion Our results indicated the possibility that the supplementation of melatonin and selenium, two antioxidant agents for the treatments in the rhinosinusitis rat model, might be reduced or prevent anosmia.

Investigation of age-related changes in the expression of aquaporin-1 and aquaporin-5 in the salivary glands of mice

Abstract Conclusion: The increased AQP5 expression associated with ageing in glands, which mainly secreted a serous solution, suggests a compensation for the decreased amount of saliva secretion associated with age progression. Objective: To investigate the change in aquaporin-1 (AQP1) and aquaporin-5 (AQP5) expression in the salivary glands in young and elder mice. Materials and method: Twelve female mice from the Balb/C genus (30–50 g) were used. The mice were separated into two groups: Group I had 2-month-old mice and Group II had 18-month-old mice. Salivary glands (glandula parotidea, glandula sublungualis, glandula submaxillaris) were excised and examined immunohistochemically and histopathologically. AQP1 and AQP5 expression of young and elder mice was evaluated using the H-score. A p-value less than 0.05 was considered statistically significant. Results: Upon histopathological examination, the acini of glands were found to be atrophic in elder mice. The number and diameter of intercalated ducts were increased. Indeed, the amount of adipose tissue in the gland was increased. Upon immunohistochemical examination, both AQP1 and AQP5 levels in sublingual glands of elder mice were increased (p < 0.01 and p < 0.001, respectively). However, only AQP5 levels were increased in the parotid gland of elder mice (p < 0.01).

MBL, P2X7, and SLC11A1 gene polymorphisms in patients with oropharyngeal tularemia

Abstract Conclusion: A significant association was found of oropharyngeal tularemia with SLC11A1 allele polymorphism (INT4 G/C) and MBL2 C + 4T (P/Q). These results indicate C allele and Q allele might be a risk factor for the development of oropharyngeal tularemia. Aim: This study aimed to investigate the relationship of SLC11A1, MBL, and P2X7 gene polymorphism with oropharyngeal tularemia. Methods: The study included totally 120 patients who were diagnosed with oropharyngeal tularemia. Frequencies of polymorphisms in the following genes were analyzed both in the patient and control groups in the study: SLC11A1 (5’(GT)n Allele 2/3, Int4 G/C, 3’ UTR, D543N G/A), MBL (MBL2 C + 4T (P/Q), and P2X7 (−762 C/T and 1513 A/C). Results: Among all polymorphisms that were investigated in this study, SLC11A1 gene showed a significance in the distriburtion of polymorphism allelle frequency at the INT4 region. Frequency of C allele was 54 (28%) in patients with oropharyngeal tularemia, and 31 (13%) in the control group (p = 0.006 and OR = 1.96 (1.21–3.20)). An association was detected between MBL2 C + 4T (P/Q) gene polymorphism and oropharyngeal tularemia (p < 0.005 and OR = 0.30 (0.19–0.48)). No significant relation was found between P2X7 (−762 C/T and 1513 A/C) gene polymorphism and oropharyngeal tularemia in this study (p > 0.05).

A new classification for septal perforation and effects of treatment methods on quality of life

INTRODUCTION Septal perforation is a condition characterized by loss of cartilage and/or bony structures along with the mucoperichondrium and mucoperiosteum lining them. The etiology includes a history of nasal surgery or trauma, nose picking, bilateral septal cauterization, overuse of nasal sprays, cocaine abuse, vasculitis, and malignancies. OBJECTIVE Comparison of quality of life in patients with septal perforation after conservative or surgical treatment, and a new approach for the determination of the diameter of the perforation from a different point of view. METHODS The diameter of septal perforation, total vertical diameter of septum, and horizontal diameter of the perforation were measured in a total of 34 patients. Nineteen of the patients underwent surgical septal perforation repair, and 15 of them received septal button application. The patients were asked to complete the Glasgow Benefit Inventory quality of life questionnaire. RESULTS The septal perforation successfully healed in 18 of 19 patients who underwent surgical treatment. The quality of life scores were statistically significantly higher in the surgical treatment group when compared to the button group (p<0.05). CONCLUSION The septal perforation classification we propose would be beneficial for providing realistic dimensions, treatment methods, and surgical techniques.

Hereditary angioedema type 2 presented as an orbital complication of acute rhinosinusitis

Hereditary angioedema is an autosomal dominant and life-threatening disorder characterized by recurrent episodes of non-pitting edema affecting the skin, respiratory system and digestive tracts and caused by a congenital deficiency or function defect of the C1 esterase inhibitor. Preseptal cellulitis is defined as an infection of the tissues of the anterior orbital septum. It is generally caused by complications from an upper respiratory tract infection, dacryocystitis, dermal infection, and, rarely, sinusitis. The disease presents with orbital pain, edema on the eyelids, erythema, and fever. In this case, a child with hereditary angioedema type 2 who presented as mimicking a complication of acute sinusitis is discussed.

Evaluation of iron and zinc levels in recurrent tonsillitis and tonsillar hypertrophy

OBJECTIVES The aim of this study is to look into the roles of iron and zinc metals in etiopathogenesis of recurrent tonsillitis and tonsillar hypertrophy by evaluating the levels of iron and zinc elements in the palatine tonsillar tissue. METHODS In total, 40 patients who underwent a tonsillectomy to treat recurrent tonsillitis and tonsillar hypertrophy were included in the study. Patients were classified into two groups, recurrent tonsillitis and tonsillar hypertrophy, determined by the results of clinical and histopathological examination. The levels of iron and zinc elements were determined for each tonsillar tissue sample. RESULTS There was a significant difference in the iron and zinc concentrations (p<0.001) between the tonsillar hypertrophy and recurrent tonsillitis groups. The levels of iron and zinc were significantly lower in the recurrent tonsillitis group. CONCLUSIONS This study suggests that low tissue concentrations of iron and zinc may lead to recurrent tonsillitis.